{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T06:41:27Z","timestamp":1696228887747},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,4,27]],"date-time":"2015-04-27T00:00:00Z","timestamp":1430092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Foundation for Liver and Gastrointestinal Research in Rotterdam"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aim<\/jats:title><jats:p>Pegylated interferon\u2010based treatment is still the backbone of current hepatitis <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content> therapy and is associated with bone marrow suppression and an increased risk of infections. The aim of this retrospective cohort study was to assess the risk of infections during interferon\u2010based treatment among patients with chronic hepatitis C virus (<jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content>) infection and advanced hepatic fibrosis and its relation to treatment\u2010induced neutropenia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cohort study included all consecutive patients with chronic <jats:styled-content style=\"fixed-case\">HCV<\/jats:styled-content> infection and biopsy\u2010proven bridging fibrosis or cirrhosis (<jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>shak 4\u20136) who started treatment between 1990 and 2003 in five large hepatology units in <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>urope and <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>anada. <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>eutrophil counts between 500\u2013749\/\u03bcL and below 500\/\u03bcL were considered as moderate and severe neutropenia, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study included 723 interferon\u2010based treatments, administered to 490 patients. In total, 113 infections were reported during 88 (12%) treatments, of which 24 (21%) were considered severe. Only one patient was found to have moderate neutropenia and three patients were found to have severe neutropenia at the visit before the infection. Three hundred and twelve (99.7%) visits with moderate neutropenia and 44 (93.6%) visits with severe neutropenia were not followed by an infection. Multivariable analysis showed that cirrhosis (odds ratio [<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>] 2.85, 95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] 1.38\u20135.90, <jats:italic>P<\/jats:italic>\u2009=\u20090.005) and severe neutropenia at the previous visit (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 5.42, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.34\u201322.0, <jats:italic>P<\/jats:italic>\u2009=\u20090.018) were associated with the occurrence of infection, while moderate neutropenia was not. Among a subgroup of patients treated with pegylated interferon, severe neutropenia was not significantly associated (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.63, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.19\u201314.2, <jats:italic>P<\/jats:italic>\u2009=\u20090.660).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large cohort of patients with bridging fibrosis and cirrhosis, infections during interferon\u2010based therapy were generally mild. Severe interferon\u2010induced neutropenia rarely occurred, but was associated with on\u2010treatment infection. Moderate neutropenia was not associated with infection, suggesting that current dose reduction guidelines might be too strict.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.12929","type":"journal-article","created":{"date-parts":[[2015,2,14]],"date-time":"2015-02-14T03:23:01Z","timestamp":1423884181000},"page":"1057-1064","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Risk of infections during interferon\u2010based treatment in patients with chronic hepatitis C virus infection and advanced hepatic fibrosis"],"prefix":"10.1111","volume":"30","author":[{"given":"Raoel","family":"Maan","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Erasmus MC University Medical Center Rotterdam  Rotterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adriaan J","family":"van der Meer","sequence":"additional","affiliation":[{"name":"Department of 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